Paranoia is a state characterized by a chronic sense of anxiety and mistrust. Depending on the form it takes and the way symptoms are expressed, it can be a symptom of several distinct, diagnosable mental illnesses.

Some forms of paranoia affect only one particular aspect of a person’s life. Others are generalized and may interfere with decision-making and relationships.

Learn about the causes of paranoia, how to find help, and tips for dealing with paranoia in a friend or family member.

What Is Paranoia?The term “paranoid” is often misused. We casually describe someone as being paranoid if he expresses suspicion or feels exploited, mistreated, or oppressed more often than others. In most cases, these reactions indicate low self-esteem, pessimism, or perhaps a skewed outlook shaped by negative experiences.

True paranoia is an extreme, specific, and unmistakable symptom of several serious disorders. Following is an overview of each, with a corresponding description of symptoms.

Paranoid SchizophreniaThis mental illness is marked by a disconnection from reality. Schizophrenia is a neurologically-based disorder in which a person’s perceptions do not match the facts of his environment. The paranoid subtype is characterized by specific ideations, hallucinations, and highly unrealistic beliefs.

Symptoms include:

Delusions of persecution - The person may believe bizarre scenarios in which others are “out to get him or her”.

*Delusions of grandeur - Commonly held delusions include believing the person has a relationship with a famous or historical individual, or thinking he can fly.

Hallucinations - Paranoid schizophrenics often hear voices. The content of the hallucination is usually derogatory, or instructs the person to take certain actions that could hurt himself or others.

Anxiety, anger, aloofness, and argumentativeness - He may also patronize others or be extremely intense in his dealings with others. A tendency toward violence is possible.

Other symptoms normally associated with schizophrenia are not usually present in people with the paranoid subtype.

Jealous Type - The jealous type exhibits delusions involving the imagined unfaithfulness of a partner or spouse. The delusions are not based on actual events, but rather on the person’s faulty interpretation.

Persecutory Type - The persecutory type involves delusions based on a belief that some group or faction is intentionally pursuing the person with the intent to do specific harm.

Anger and the possibility of violence against the perceived enemy are common symptoms.

Paranoid Personality DisorderSome characteristics are shared between paranoid personality disorder and the previously mentioned illnesses. In the personality disorder, however, the paranoid beliefs about the intentions of others persist, even in the absence of hallucinations. Also, people who suffer from paranoid personality disorder show symptoms early, often beginning in childhood, whereas schizophrenia and delusional disorder do not emerge until the adult enters his 20s. Other symptoms of paranoid personality disorder include:

- Suspicions that others harbor malevolent intentions against him.

- Unfounded Doubts surrounding the fidelity of friends and lovers.

- Misinterpreting harmless statements and actions of others.

- Unwillingness to confide in people.

- Overreacts to perceived attacks.

Borderline Personality DisorderThis bears mentioning because paranoid beliefs and illusions are sometimes held by people with BPD. However, paranoia is not the predominant factor.

BPD is a disorder that primarily affects a person’s ability to relate in healthy ways to others, with unstable self-image and overreactive emotional responses as its most significant symptoms. Paranoia is evident in BPD, mainly in terms of explosive and often unprovoked suspicions about another’s faithfulness or commitment. BPD occurs primarily in women, whereas the other disorders occur most often in men.

Treatment OptionsTreatment for paranoia includes psychotherapy and medication.

- Behavioral therapy helps an individual learn to relax and manage anxiety symptoms. It also teaches him new interpersonal skills that allow him to function more satisfactorily.

- Cognitive therapy allows an individual to weigh the usefulness of his beliefs and choose to replace them with more realistic thoughts.

It has been noted that beginning psychotherapy is difficult in cases of paranoia. Trust is the most essential element in a therapeutic relationship. The nature of disorders involving paranoia makes it difficult for the client to open up and allow trust to be established. Progress will be slow at first.

-Antipsychotic medication often is necessary, especially in schizophrenia, to control psychotic symptoms. Most people respond well to medication. Several types are commonly used.

Atypical antipsychotics became available almost two decades ago. Clozapine was first introduced, but serious side effects sometimes occur. Newer drugs have since been introduced, including risperidone, olanzapine, and aripiprazole, which work as well as clozapine and have less serious side effects.

The previous generation of antipsychotics included haloperidol and chlorpromazine, which were effective in treating hallucinations, but deadened motivation and emotional response.

Antidepressants are sometimes required, as depression may co-exist with other symptoms.

How to Cope with ParanoiaLiving with someone who has been diagnosed with paranoia requires patience, compassion, and strong personal boundaries. The following tips can help you provide the necessary support and assistance to help him in his struggle to overcome paranoia.

Encourage compliance with treatment - His mistrust may interfere with his willingness to take prescribed medications or attend therapy sessions. This occurs commonly in people being treated for paranoia and slows their recovery significantly. Encourage him to follow his treatment program.

Be accepting, yet firm - Delusions are very real to the person having them. Don’t confront the person about their beliefs or attempt to help him reality-test. Communicate that you respect his beliefs, but don’t pretend to share them. Be honest about your own perceptions.

Offer clarification - You can help him cope with his suspicion and mistrust by encouraging him to voice his thoughts, and then explaining your actions in a neutral and non-defensive way.

Anticipate triggers - Symptoms may intensify under new or stressful circumstances. Offer sufficient information in advance so the person will be better prepared for changes and for a possible worsening of symptoms.

Emphasize his strengths - People with paranoia are often very intelligent and high-functioning aside from interpersonal relationships. Be aware of him as a whole person, not just in terms of his symptoms. Focus on his positive traits and behaviors.

Taking Care of YourselfCaring for a paranoid partner can take a toll. Providing for his needs requires that you continue to meet your own. Avoid becoming overwhelmed by taking these precautions.

Seek balance - Give other aspects of life equal time. Have conversations with him about topics other than his illness. Engage in interests unrelated to his condition. Remember that his paranoia is only one concern in your life, not the center of it.

Maintain your health - Becoming run down will make you less able to provide for his care and lessen your ability to cope. Eat properly, exercise, and get adequate rest. It will increase your energy, improve your state of mind, and enable you to handle the increased stress.

Educate yourself - Learn all you can about his type of paranoia. Strive to understand the symptoms you observe and the treatment he is undergoing. Ask his doctor for clarification and additional information.

Get support - Consider therapy to help you accept his diagnosis and learn coping skills. Ask family and friends for encouragement or assistance. Find a support group for families of people with paranoia.

Coping with a loved one’s paranoia is difficult, and recovery is only possible with professional care. Seek assistance for him and for yourself. Learn all you can to better prepare you for the challenges you will face. Most importantly, remember that you are not alone, and a better future is possible.

Always Consult Your Physician FirstAlthough it is helpful to get health information by reading and talking with friends, make sure you consult your doctor first before trying any new treatment or changing your diet. Remember that the U.S. Food and Drug Administration does not strictly regulate the strength, purity or safety of herbs and supplements. Be sure to always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, speak with your doctor before taking medical action or changing your health routine. This information is not intended to replace the advice of a doctor. LifeScript disclaims any liability for the decisions made by its readers based on the information provided.

Which Personality Disorder Do You Have?Everyone has idiosyncrasies that might lend themselves to a personality disorder. Take a look at the silly side of being addictive, compulsive, dependent, and antisocial and keep an open mind while you take this personality disorder quiz. Discover your neurosis and find out which quirky personality disorder best defines you.